Provider Demographics
NPI:1982352738
Name:OHIO IMPLANT CENTER PAUL MIKHLI DDS INC
Entity Type:Organization
Organization Name:OHIO IMPLANT CENTER PAUL MIKHLI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKHLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-424-5091
Mailing Address - Street 1:3690 ORANGE PL STE 525
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4479
Mailing Address - Country:US
Mailing Address - Phone:440-424-5091
Mailing Address - Fax:
Practice Address - Street 1:3690 ORANGE PL STE 525
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4479
Practice Address - Country:US
Practice Address - Phone:440-424-5091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0000OtherDENTAL INSURANCES